Staphylococcal scalded skin syndrome: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Changes made per Mahshid's request)
 
(5 intermediate revisions by 2 users not shown)
Line 1: Line 1:
{{Infobox Disease |
__NOTOC__
  Name          = Staphylococcal scalded skin syndrome |
'''For patient information, click [[Staphylococcal scalded skin syndrome (patient information)|here]]'''
  Image          =|
  Caption        = An infant with Staphylococcal scalded skin syndrome|
  DiseasesDB    = 29437 |
  ICD10          = {{ICD10|L|00||l|00}} |
  ICD9          = {{ICD9|695.81}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 001352 |
  eMedicineSubj  = derm |
  eMedicineTopic = 402 |
  eMedicine_mult = {{eMedicine2|emerg|782}} |
  MeshID        = D013206 |
}}
'''Staphylococcal scalded skin syndrome''', SSSS, also known as '''Pemphigus neonatorum''' or '''Ritter's disease''',<ref name="Bolognia">{{cite book | author = Rapini RP, Bolognia JL, Jorizzo JL | title = Dermatology: 2-Volume Set | publisher = Mosby | location = St. Louis | year = 2007 | pages = | isbn = 1-4160-2999-0 }}</ref> or '''Localized bullous impetigo''' is a [[dermatology|dermatological]] condition caused by ''[[Staphylococcus aureus]]''.


==Pathophysiology==
{{SSSS}}
The [[syndrome]] is induced by epidermolytic [[exotoxin]]s ([[exfoliatin]])<ref>{{DorlandsDict|three/000037652|exfoliatin}}</ref> A and B, which are released by ''S. aureus'' and cause detachment within the epidermal layer; by breaking down tight-junctions.  One of the exotoxins is produced by the bacterial chromosome, while the other is produced by a [[plasmid]].  (Bacterial plasmids are pieces of self-replicating DNA that often code for secondary characteristics, such as antibiotic resistance, and toxin production.) These exotoxins are proteases that cleave desmoglein-1, which normally holds the [[Stratum granulosum|granulosum]] and [[Stratum spinosum|spinosum]] layers together.
{{CMG}}


==Signs and Symptoms==
{{SK}} Ritter's disease; pemphigus neonatorum; localized bullous impetigo; SSSS.


The disease presents with the widespread formation of fluid filled blisters that are thin walled and easily ruptured and the patient can be positive for [[Nikolsky's sign]]. '''Ritter's Disease of the Newborn''' is the most severe form of SSSS with similar signs and symptoms. SSSS often includes a widespread painful erythroderma, often involving the face, diaper, and other intriginous areas. Extensive areas of desquamation might be present. Perioral crusting and fissuring are seen early in the course. Unlike [[toxic epidermal necrolysis]], SSSS spares the mucous membranes. It is most common in children under 6 years, but can be seen in adults who are immunosuppressed or have renal failure.
==[[Staphylococcal scalded skin syndrome overview|Overview]]==
 
==[[Staphylococcal scalded skin syndrome historical perspective|Historical Perspective]]==
 
==[[Staphylococcal scalded skin syndrome pathophysiology|Pathophysiology]]==
 
==[[Staphylococcal scalded skin syndrome causes|Causes]]==
 
==[[Staphylococcal scalded skin syndrome differential diagnosis|Differentiating Staphylococcal scalded skin syndrome from other Diseases]]==
 
==[[Staphylococcal scalded skin syndrome epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Staphylococcal scalded skin syndrome risk factors|Risk Factors]]==
 
==[[Staphylococcal scalded skin syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
The diagnosis of SSSS is made clinically. This is sometimes confirmed by isolation of ''S. aureus'' from blood, mucous membranes, or skin biopsy; however, these are often negative. Skin biopsy may show separation of the superficial layer of the epidermis, differentiating SSSS from TEN, wherein the epidermal-dermal layer is separated in the latter. SSSS may be difficult to distinguish from toxic epidermal necrolysis and pustular psoriasis.
 
[[Staphylococcal scalded skin syndrome history and symptoms|History and Symptoms]] | [[Staphylococcal scalded skin syndrome physical examination|Physical Examination]] | [[Staphylococcal scalded skin syndrome laboratory findings|Laboratory Findings]] | [[Staphylococcal scalded skin syndrome other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
The mainstay of treatment for SSSS is supportive care along with eradication of the primary infection. Conservative measures include rehydration, antipyretics, management of thermal burns, and stabilization. Parenteral antibiotics to cover ''S. aureus'' should be administered. Most strains of ''S. aureus'' implicated in SSSS have penicillinases, and are therefore penicillin resistant. Therefore, treatment with Nafcillin, oxacillin, or vancomycin is typically indicated. Clindamycin is sometimes also used because of its inhibition of [[exotoxin|exotoxins]].
==Prognosis==
The prognosis of SSSS in children is excellent, with complete resolution within 10 days of treatment, and without significant scarring. However, SSSS must be differentiated carefully from toxic epidermal necrolysis, which carries a poor prognosis. The prognosis in adults is generally much worse, and depends upon various factors such as time to treatment, host immunity, and comorbidities.


==History==
[[Staphylococcal scalded skin syndrome medical therapy|Medical Therapy]] | [[Staphylococcal scalded skin syndrome prevention|Prevention]] | [[Staphylococcal scalded skin syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Staphylococcal scalded skin syndrome future or investigational therapies|Future or Investigational Therapies]]


The clinical features were first described in 1878 by Baron Gottfried Ritter von Rittershain, who observed 297 cases among children in a single Czechoslovakian children's home over a 10-year period.<ref name="pmid15816826">{{cite journal | author = Mockenhaupt M, Idzko M, Grosber M, Schöpf E, Norgauer J | title = Epidemiology of staphylococcal scalded skin syndrome in Germany | journal = J. Invest. Dermatol. | volume = 124 | issue = 4 | pages = 700–3 | year = 2005 | month = April | pmid = 15816826 | doi = 10.1111/j.0022-202X.2005.23642.x }}</ref>
==Case Studies==


==See also==
[[Staphylococcal scalded skin syndrome case study one|Case #1]]
==Related Chapters==
* [[Duke's disease]]
* [[Duke's disease]]
* [[List of cutaneous conditions]]
* [[Toxic epidermal necrolysis]]
* [[List of conditions caused by problems with junctional proteins]]
 
==References==
{{reflist}}


{{Gram-positive bacterial diseases}}
{{Gram-positive bacterial diseases}}
Line 49: Line 43:
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Bacterium-related cutaneous conditions]]
[[Category:Bacterium-related cutaneous conditions]]
[[Category:Infectious disease]]
 


{{Cutaneous-infection-stub}}
{{Cutaneous-infection-stub}}
Line 63: Line 57:
[[sl:Stafilokokni eksfoliativni dermatitis]]
[[sl:Stafilokokni eksfoliativni dermatitis]]
[[sv:Staphylococcal scalded skin syndrome]]
[[sv:Staphylococcal scalded skin syndrome]]
{{WH}}
{{WS}}

Latest revision as of 19:07, 18 September 2017

For patient information, click here

Staphylococcal scalded skin syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Staphylococcal scalded skin syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Staphylococcal scalded skin syndrome On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Staphylococcal scalded skin syndrome

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Staphylococcal scalded skin syndrome

CDC on Staphylococcal scalded skin syndrome

Staphylococcal scalded skin syndrome in the news

Blogs on Staphylococcal scalded skin syndrome

Directions to Hospitals Treating Staphylococcal scalded skin syndrome

Risk calculators and risk factors for Staphylococcal scalded skin syndrome

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Ritter's disease; pemphigus neonatorum; localized bullous impetigo; SSSS.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Staphylococcal scalded skin syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:Cutaneous infections


Template:Cutaneous-infection-stub

ca:Síndrome de la pell escaldada estafilocòccica de:Staphylococcal scalded skin syndrome nl:Staphylococcal scalded skin syndrome sl:Stafilokokni eksfoliativni dermatitis sv:Staphylococcal scalded skin syndrome

Template:WH Template:WS